Estimated reading time: 5 minutes
Birth & Sex: The power and the passion by Sheila Kitzinger, London: Pinter & Martin
Reviewed by Naomi Stadlen, London, UK
Photo: Kailee Riches Photography
Review republished in memory of Sheila Kitzinger who died in April 2015.
The seventh of the ten concepts which sum up the philosophy of La Leche League states: “Alert, active participation by the mother in childbirth is a help in getting breastfeeding off to a good start.”
Sheila Kitzinger, the English social anthropologist and woman-centred childbirth educator, has fought to enable women to enjoy “active participation” in giving birth. Her many books are in harmony with La Leche League values, and she has been a speaker at LLL conferences. Her contribution to our understanding of childbirth has been, and continues to be, unique.
The final words of her new work, Birth & Sex are: “We are on the threshold of reclaiming spontaneous childbirth.” What does she mean? Isn’t childbirth safer than it ever has been, with most women going to hospital and giving birth under the supervision of well-trained medical health professionals?
Kitzinger challenges this perception: “Birth is usually treated as a medico-surgical crisis. Women are fed into the hospital system at one end, are processed through it, and come out at the other with a baby.”  She adds later: “The obstetric view of childbirth is that it is a medical event conducted by a team of professionals, in an intensive care setting.” 
Succinctly, Kitzinger describes the effect of this view: “Women became treated as containers to be opened and relieved of their contents within strictly limited time constraints, and attention was concentrated on a bag of muscle and a birth canal rather than a person.”  Technical innovations to monitor the birth made it easier to ignore the person of the mother. “It is almost as if it is the monitor which is having the baby, and all eyes are fixed on it.” 
These technical innovations have had a negative effect on mothers giving birth. “It meant that women could no longer trust their bodies…. Spontaneous feelings are rejected, as women in labour are required to put on a performance in an alien environment, often in front of total strangers.” She adds: “For those who have been through that ordeal, references to the sexuality of birth must sound like the ravings of someone who is seriously mentally disturbed.” 
Kitzinger offers a completely different paradigm. “When a woman is helped to do whatever she feels like doing in the second stage of labour, adopting positions, moving and breathing in any way she wants to, the second stage can become an intense sexual experience.”  She explains: “In the second stage of labour each contraction can bring a series of orgasms as each one climaxes in pushing and release, mounts again, culminates in another, and so on.”  Kitzinger describes a woman’s orgasm in language both simple and lyrical: she shows how a woman uses the same muscles and the same breathing rhythms that are used in sexual intercourse in giving birth. This kind of birth-giving creates a special moment for the first meeting of mother and baby. “A peak sexual experience, the birth passion, becomes the welcoming of a new person into life.” 
However, Kitzinger is quick to point out that a woman whose birth was different, a painful ordeal, “has not failed to be a ‘real mother’.”  She wants to demonstrate how fulfilling the experience of giving birth can be, but at the same time she shows compassion to those women who suffer in giving birth. She writes: “I was fed up with women being blamed for everything that happened to them.” 
But if birth can be so wonderful, why do so many women have births that are painful, terrifying and humiliating? In Birth & Sex, Kitzinger offers a very simple answer.
Women, she writes, have a pattern of childbirth imposed upon them.
“‘Push! Push! Don’t waste your contraction!… Take a deep breath, hold it. Now come on, you can do better than that. Don’t let your breath go! Take another one!…’ The idea behind this is that she should be pushing right through a contraction, using every second of it, and putting her utmost strength into it. It is the exact opposite of the female orgasm. What has happened is that a male model of physiological activity is being imposed on women in childbirth. The pattern of male orgasm—stiffen, hold, force through, shoot!—is distorting her own spontaneous psychosexual behaviour. Instead of the wave-like rhythms of female orgasm, bearing down is treated like one long ejaculation.” 
This is an important assertion. Kitzinger may be the first person to have thought of it.
But how accurate is Kitzinger’s description of male orgasm? Wilhelm Reich, who published his now-classic, The Function of the Orgasm in 1927 [English translation, 1942], describes the sexual sensations of men and women, not as two different patterns, but as similar. He was clear that men did experience wave-like sexual feelings. However, he deplored what he called “compulsive characters” who would produce “violent frictions” in contrast to sensations “mutual, slow, spontaneous and effortless;” this was printed in italics, so he obviously thought these gentle sensations were important.  Perhaps the more violent pattern so vividly described by Kitzinger corresponds to Reich’s “compulsive character” rather than being characteristic of all men.
Mothers are also often urged to push their babies out as if they were having a bowel movement. “Push down! Go to the toilet!” Straining and pushing don’t seem optimal ways of going to the toilet.
Kitzinger shows that women (and surely their male partners too) have been confused by images derived from aggressive ways both of defecating and of reaching an orgasm. Kitzinger says these practices, very common in hospital births, constrain women from giving birth gently and spontaneously.
Kitzinger has written many books on childbirth. Her first, The Experience of Childbirth published in 1962, opened with a chapter called “Childbirth With Joy.” The book contains many quotations from mothers’ own birth stories which describe a variety of joyful experiences. For half a century, Kitzinger has worked consistently both to show that childbirth can be a time of sexual fulfilment, and also to name and explore the many impediments which make this difficult for so many mothers.
Her unique achievement is evident if one reads comparable works, for example, The Function of the Orgasms (2009) by her near contemporary, Dr. Michel Odent. This, too, is a fine work, describing centuries of “powerful negative cultural conditioning” which interfere with childbirth and the period immediately after. Yet Odent frequently seems to lose sight of the autonomy of an individual mother. “From a practical perspective … a labouring woman needs to be protected from any sort of stimulation of her neocortex,” he states on his penultimate page. Isn’t this something for a mother to decide for herself?
Kitzinger by contrast is always personal. In this way, she and we are always present throughout her work. Where others who write to inform mothers are often didactic and overpowering, Kitzinger succeeds in being informative, while brimming with humanity, and so she is truly empowering.
1 Birth & Sex, pages 118–19. 2 ibid. page 159.
3 ibid. page 158.
4 ibid. page 74
5 ibid. page 159.
6 ibid. page 27.
7 ibid. page 16.
8 ibid. page 28.
9 ibid. page 29.
10 ibid. page 11.
11 ibid. pages 77-78.
12 Wilhelm Reich, The Function of the Orgasm. London: Panther Books edition, 1968, page 116.
Naomi Stadlen is a La Leche League Leader in London. She has three children and three grandchildren. She has written two books, both approved by La Leche League: What Mothers Do (2004) and How Mothers Love (2011). Sheila Kitzinger was her antenatal teacher. Naomi wrote this review in 2013.